Infant Mortality written reply in the Lok Sabha here today.

Infant Mortality written reply in the Lok Sabha here today.As per the Sample Registration Report (SRS) of Registrar General of India, the major causes of deaths of children (2010-13) are- Prematurity & low birth weight (29.8%), Pneumonia (17.1%), Diarrhoeal disease (8.6%), Other Non-Communicable Diseases (8.3%), Birth asphyxia & birth trauma (8.2%), Injuries (4.6%), Congenital anomalies (4.4%),

Ill-defined or cause unknown (4.4%), Acute bacterial sepsis and severe infections (3.6%), Fever of unknown origin (2.5%) and All Other Remaining Causes (8.4%). Multi-drug resistance in children may adversely affect treatment outcome. As per report published by Lancet in 2016 approximately 57 thousand neonatal deaths each year in India may be attributable to neonatal sepsis caused by bacteria resistant to first-line antibiotics.

United Nations has recently set Sustainable Development Goals and Targets. The target for India is to attain U5MR of 25/1000 live births by 2030.

The Government of India is implementing the following interventions under the National Health Mission (NHM) all across the country to reduce infant mortality rate:

       I.            Promotion of Institutional deliveries through cash incentive under Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) which entitles all pregnant women delivering in public health institutions to absolutely free ante-natal check-ups, delivery including Caesarean section, post-natal care and treatment of sick infants till one year of age.

    II.            Strengthening of delivery points for providing comprehensive and quality Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) Services, ensuring essential newborn care at all delivery points, establishment of Special Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies. Home Based Newborn Care (HBNC) is being provided by ASHAs to improve child rearing practices. India Newborn Action Plan (IANP) was launched in 2014 to make concerted efforts towards attainment of the goals of “Single Digit Neonatal Mortality Rate” and “Single Digit Stillbirth Rate”, by 2030.

 III.            Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted in convergence with Ministry of Women and Child Development. Village Health and Nutrition Days (VHNDs) are observed for provision of maternal and child health services and creating awareness on maternal and child care including health and nutrition education. Ministry of Health and Family Welfare launched MAA-Mothers’ Absolute Affection programme in August 2016 for improving  breastfeeding practices (Initial Breastfeeding within one hour, Exclusive Breastfeeding up to six months and complementary Breastfeeding up to two years)through mass media and capacity building of health care providers in health facilities as well as in communities.

 IV.            Universal Immunization Programme (UIP) is being supported to provide vaccination to children against many life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B and Measles. Pentavalent vaccine has been introduced all across the country and “Mission Indradhanush” has been launched to fully immunize more than 89 lakh children who are either unvaccinated or partially vaccinated; those that have not been covered during the rounds of routine immunization for various reasons.

    V.            Name-based tracking of mothers and children till two years of age (Mother and Child Tracking System) is done to ensure complete antenatal, intranatal, postnatal care and complete immunization as per schedule.

 VI.            Rashtriya Bal Swasthya Karyakram (RBSK) for health screening, early detection of birth defects, diseases, deficiencies, development delays including disability and early intervention services has been operationalized to provide comprehensive care to all the children in the age group of 0-18 years in the community.

VII.            Some other important interventions are Iron and folic acid (IFA) supplementation for the prevention of anaemia among the vulnerable age groups, home visits by ASHAs to promote exclusive breast feeding and promote use of ORS and Zinc for management of diarrhoea in children.

VIII.            Government of India has adopted the Reproductive, Maternal, Newborn, Child and Adolescent Health Strategy (RMNCH+A) to improve maternal and child health outcomes. The RMNCH+A strategy recognize that child health and survival is inextricably linked to women’s health across all life stages. Besides this, 184 high priority districts with relatively weaker status of maternal and child health indicators have been identified, for the intensification of RMNCH+A efforts.

As per the Pneumonia and Diarrhoea Progress Report, of the International Vaccine Access Centre (IVAC), India tops the list of 15 high burden countries in terms of deaths due to pneumonia and diarrhoea. The reasons being high prevalence of underlying under-nutrition, low birth weight and indoor air pollution.

                 

State/UT-wise details of pneumonia deaths among children during the last three years are not maintained at central level.

Government of India, under National Health Mission, is undertaking following interventions for prevention and control of pneumonia among children:

·         Promotion of infant and young child feeding practices to prevent onset of malnutrition,

·         Vitamin A supplementation

·         Vaccination for diphtheria, pertusis, measles and Hib vaccination

·         Improved case management for pneumonia at community and health facilities

·         Training of health personnel on integrated management of neonatal and childhood illness including pneumonia

·         Promotion of hand washing and personal hygiene through IEC activities etc.

The State wise Under 5 Mortality Rate (U5MR) is given below:

States

2014

India

45

Andhra Pradesh  

40

Assam           

66

Bihar           

53

Chhattisgarh

49

Delhi           

21

Gujarat         

41

Haryana         

40

Himachal Pradesh

36

Jammu & Kashmir 

35

Jharkhand

44

Karnataka       

31

Kerala          

13

Madhya Pradesh  

65

Maharashtra     

23

Odisha         

60

Punjab          

27

Rajasthan       

51

Tamil Nadu      

21

Telangana

37

Uttar Pradesh   

57

Uttarakhand

36

West Bengal     

30

Source: Sample Registration System report 2014, Registrar General of India

The Minister of State (Health and Family Welfare), Sh Faggan Singh Kulaste stated this in a written reply in the Lok Sabha here today.